Nutritional supplements, also known as meal replacement drinks or shakes, can be a helpful tool for elderly who struggle to eat nutrient-rich foods. This can be due to several factors, including swallowing and feeding issues (such as Dysphagia), food insecurity, financial worries or the requirement of texture modified diets.
Studies have shown that monitored use of oral nutritional supplements such as meal replacement shakes and other nutrition products can lead to improvement in weight, protein and energy intake, nutritional status, physical function, quality of life and help reduce the required length of stay in acute care.
Nutritional supplements may be required if somebody is:
- Struggling with a loss of appetite or dysphagia (difficulty swallowing)
- Having difficulty preparing balanced meals and/or managing their dietary needs
- Recovering from surgery or an illness
- Has specified nutritional deficiencies or requirements (high caloric or protein intake)
- Dental problems that limit the types of food that can be eaten
- Psychological distressers (such as cognitive decline due to dementia)
- Medications that may be disrupting appetite
- Injury and/or disability
As community care and nursing professionals, it is essential to understand the nutritional needs of the elderly, when a nutritional supplement may be needed and what type of nutritional supplement will work best for your situation.
Health Benefits of Nutritional Supplement Drinks for Elderly
It’s always important to consult your doctor or a healthcare professional before adding nutritional supplements into a dietary rotation as there can be some risks and drawbacks of nutritional drinks. However, some of the benefits of nutritional supplement drinks are as follows:
Prevention of Unintentional Weight Loss
A key benefit of nutritional supplements is that they’re formulated with a balance of protein, carbohydrates and fats. This means that not only are they a simple and palatable way for the elderly to ingest calories, but they can also help ensure that the correct nutrients are being consumed for continued health.
Elderly who may need to stop unintended weight loss or weight gain may benefit from easy access to a simple and significant source of calories. Increasing caloric intake may also lead to more awareness, improved mood and energy levels.
Increased Protein Intake
Loss of appetite and/or trouble preparing healthy meals may lead to malnourishment in elderly populations. Nutritional drinks that balance fats, carbohydrates and protein should also contain calcium, vitamins, nutrients and fibre.
It’s also important to look for a formula that addresses your unique dietary requirements. For those who struggle to prepare proper meals, adding an easy-to-consume source of protein (such as a nutritional supplement or even something more basic like electrolyte drinks) to their daily diet may help support muscle health, strength and hydration.
Convenience and Effectiveness
Sometimes the elderly have swallowing difficulties or no longer find eating pleasurable so they stop consuming as much food. This means that they’re at risk of not getting enough calories and vitamins in their diet. Nutrition drinks and shakes are easy to find in grocery stores and designed to meet the goals of boosting calories and nutrition with rich, appetizing flavors. A ready-made product that helps get a senior to “eat” is a welcome relief for caregivers faced with this daily challenge.
Types of Nutritional Supplement Drink Options
Oral nutritional supplements are a useful tool to increase protein, energy and nutrient intake. The main categories of nutritional supplements you’ll find fall under nutritional powder, liquid nutrients and pudding. While they all contain nutrients, the exact mixes and uses for them can differ. Always consult a healthcare professional for help identifying which may be the most suitable for your situation, however knowing the best use-cases for different nutritional supplements can help you better identify which formulation may be best for your situation.
Nutritional Shakes & Powders
Nutritional shakes are what are known as standard oral supplements, and can be for either general consumption or condition-specific needs. These are suitable for individuals who have some oral intake, but who are struggling to achieve adequate nutrition through a standard food diet alone. These supplements are best taken as snacks between meals to complement normal meals. Most standard supplements are powder-based and some are marked as ‘complete’, which means that they will provide 100% of macro and micronutrient needs if taken as the only form of nutrition. Some are supplemented with fibre and others are low in lactose. The standard dilution is one calorie per mL of fluid.
Premixed Liquid Supplements
Premixed liquid supplements can be particularly useful in acute-care settings as they do not require extra mixing. Just like nutritional drinks and shakes, different liquid supplements will be more concentrated to provide more nutrition in smaller volumes.
Studies have found that the most common use of premixed liquid supplements is in tandem with medication rounds (which are often done three or four times a day). A cup with 50 to 60 mL of the supplement given at the same time as medication has been found to increase acceptance and give a significant boost to nutrient and energy intake.
Clear Liquid Supplements
The most common pre-mixed liquid nutritional supplements you’ll find are often milk-based and will vary in taste, nutrient formulation and indications for use. Clear liquid supplements have added protein and nutrients and are a useful alternative for people who do not like milk or milk-based drinks. Most clear liquid supplements will be fruit flavoured, sweet, and will provide significant nutrition even if they need to be diluted. They are suitable for use on a 'clear fluid' diet.
Nutritional Puddings
As desserts are commonly well-enjoyed by older adults and the elderly, they can also be a useful way to pack nutrition into a diet. As puddings have a high calorie count and are dairy-based, they have more sugars, fats, proteins and calcium than other desserts that may be on offer. Nutritional puddings can also be helpful for those who do not like milky or milk-based drinks, but who are happy to take custards and milky desserts.
Specialised Supplements
Designed for more specific disease states, these formulas are often used in conjunction with feeding tubes and are typically more nutrient-dense. Many specialised supplements are available for a variety of medical conditions. The use of nutritional formulas should be spoken about with a healthcare professional.
How to Choose the Right Supplement Drink for Seniors
When considering nutritional supplements, it’s important to look at the caloric content of the product to ensure that it aligns with your needs. It’s also crucial to understand the macronutrient balance, which means making sure that the product provides a balanced ratio of protein, carbohydrate, and fat.
All ingredients in a nutritional supplement should be checked to ensure it won’t interfere with any medications that are being taken, and if needed, consider a disease-specific formulation (such as when dealing with diabetes and kidney disease).
A good baseline to follow is the below nutritional ratios in a bottle for elderly:
The Path to Better Nutrition for Seniors
While there are a few alternatives to nutritional drinks, the use of oral nutrition supplements can be a valuable adjunct to the nutritional management of an older person who is malnourished or at risk of malnutrition. They should not be used in isolation from other strategies to increase oral intake. The first step should always be to attempt to increase protein and energy from food, preserving the enjoyment of preferred food and maintaining quality of life.
If a family caregiver wants to use these products, then they should be served between meals as a snack or a source of supplemental calories and nutrients, not to completely replace all meals. Caregivers who find they are starting to rely solely on these kinds of drinks or shakes for their loved ones’ meals should consult with a doctor or registered dietitian.
Sources
UMMC Health Care. (n,d.). Dysphagia Mechanical Soft Diet. https://umc.edu/Healthcare/ENT/Patient-Handouts/Adult/Speech-Language-Pathology/Swallowing/Dysphagia-Soft-Diet.html
WebMD. (July 11, 2023). What to Know About Meal Replacement Shakes. https://www.webmd.com/diet/what-to-know-about-meal-replacement-shakes
The Cochrane Database of Systematic Reviews. (April 15, 2009). Protein and energy supplementation in elderly at risk from malnutrition. https://pubmed.ncbi.nlm.nih.gov/19370584/
The BMJ. (June 29, 2020). Food and mood: how do diet and nutrition affect mental wellbeing? https://pmc.ncbi.nlm.nih.gov/articles/PMC7322666/
Medical News Today. (September 19, 2023). What are electrolyte drinks and how to make them? https://www.medicalnewstoday.com/articles/electrolytes-drinks
Australian Prescriber. (August 4, 2014). Malnutrition and nutritional supplements. https://australianprescriber.tg.org.au/articles/malnutrition-and-nutritional-supplements.html
Oscar Care Group. (September 16, 2024). Desserts for a cause! https://www.oscarcaregroup.com.au/post/desserts-for-malnutrition-aged-care